Peer assessment in medical communication skills training in programmatic assessment: A qualitative study examining faculty and student perceptions.

INTRODUCTION: Current literature recommends assessment of communication skills in medical education combining different settings and multiple observers. There is still a gap in understanding about whether and how peers assessment facilitates learning in communication skills training. METHODS: We designed a qualitative study using focus group interviews and thematic analysis, in a medical course in the Netherlands. We aimed to explore medical students' and teachers' experiences, perceptions, and perspectives about challenges and facilitating factors in PACST (Peer assessment in medical communication skills training). RESULTS: Most of the participants reported that peer feedback was a valuable experience when learning communication skills. The major challenges for the quality and credibility of PACST reported by the participants are the question whether peer feedback is critical enough for learning and the difficulty of actually engaging students in the assessment process. CONCLUSION: Teachers reviewing students' peer assessments may improve the quality and their credibility and the reviewed assessments can best be used for learning purposes. We suggest to pay sufficient attention to teachers' roles in PACST, ensuring a safe and trustworthy environment and additionally helping students to internalize the value of being vulnerable during the evaluation process.

Grading medial collateral ligament injury: comparison of MR imaging and instrumented valgus-varus laxity test-device. A prospective double-blind patient study.

PURPOSE: The role of MR imaging in grading medial collateral ligament (MCL) injury of the knee in comparison to other grading methods (clinical findings and instrumental measurement) is hardly documented in the literature. The purpose of this study is to compare the results of MR imaging in grading acute MCL injuries to the results of a clinical grading by an instrumented valgus-varus laxity tester (VVLT). MATERIALS AND METHODS: Twenty-one patients clinically suspected of acute MCL injury were tested by VVLT, a well documented and instrumented test-device. All patients subsequently underwent MR imaging of the knee. MCL injury was graded independently by VVLT and MR imaging using a classification method with reference to Petermann. RESULTS: Nineteen patients had corresponding grading results by VVLT and MR imaging (kappa, 0.83; S.E., 0.10); 14 patients had a Grade I, four a Grade II and two patients had a Grade III MR imaged MCL injury. Associated lesions were also depicted on MR imaging (bone contusion (n = 3), ACL disruption (n = 2) and medial meniscal rupture (n = 1)). CONCLUSIONS: This study shows a very high degree of agreement between the results in grading acute MCL injuries with MR imaging and an instrumented valgus-varus laxity tester (VVLT). MR imaging depicted important, clinically undetected, additional lesions which can determine the treatment of MCL injury.

[Rehabilitation of nursing home patients with a leg amputation. A retrospective study]. / Reactivering in een verpleeghuis bij patiënten met een beenamputatie. Een retrospectief onderzoek.

In order to assess the effect of rehabilitation of lower-extremity amputees in a nursing home, a retrospective study was conducted. The results were compared with existing Dutch data. Moreover, the influence of several selected factors on the results of rehabilitation was assessed. The study covered a period of five years and concerned 61 patients admitted with a lower-extremity amputation. Their median age was 73 (range 38-91) years. After rehabilitation two-thirds of the patients were able to walk with an ambulatory aid and five without; a quarter came to depend on a wheelchair. Return to home or sheltered housing was possible for almost three-quarters of the patients. Only one out of eight selected factors was in this study of influence on the results of rehabilitation i.e. motivation.

[High-flow priapism: a rare, easily treatable disorder with excellent prognosis]. / 'High-flow'-priapisme: een zeldzame, goed behandelbare aandoening met uitstekende prognose.

Four patients, men aged 33, 37, 37 and 12 years, were examined because of priapism following trauma. In all four high-flow priapism was diagnosed, based on intracavernous blood gas analysis and selective angiography. One of the men aged 37 was subsequently found to be suffering from low-flow priapism caused by chronic myeloid leukaemia (the blood gas analysis had been performed after decompression of the cavernous body). Two other patients were treated by selective internal pudendal artery embolisation. In the fourth, who developed a vascular spasm at angiography, embolisation was not performed: he recovered spontaneously. In contrast to high-flow priapism, low-flow priapism is an urological emergency for diagnosis and treatment to prevent permanent impotence.